Pelvic Floor Physio… the what, where’s, why’s and how’s!

Welcome Jenna, our new Pelvic Floor and Women’s Health Physiotherapist

Pelvic Floor and Women’s Health Physiotherapist, Jenna Mooney has completed two post graduate certificates in Pelvic Floor Physiotherapy and Exercise and Women’s Health Physiotherapy through the University of Melbourne.

She is very excited to be providing these services to the Riverina community as she believes they can make a valuable difference in people’s lives. 

Do you know what Pelvic Floor Physiotherapy is and how it may help you?
Read Jenna’s blog below to find out!

Click here to find out more about Jenna.

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Pelvic Floor Physio… the what, where’s, why’s and how’s!

What is a Pelvic Floor Physiotherapist? 

Pelvic Floor Physiotherapists are experts in the management of pelvic floor muscle dysfunction; anything from pregnancy and postnatal recovery, to bladder or bowel incontinence, to pelvic organ prolapse, to pelvic and genital pain, to preparation and recovery from surgery - a huge range of conditions!  Pelvic Floor Physiotherapists have typically undergone additional university training (beyond what is covered in the general physiotherapy degree) to gain the knowledge, skills and experience to comprehensively assess and treat these personal, often complex, conditions.

So… What and where are the pelvic floor muscles?

The pelvic floor muscles are a layer of muscles that span the base of the pelvis.  They support the pelvic organs, play a role in sexual function, and help to maintain control of the pelvic openings - your urethra (from your bladder), anus (from your bowel), and in women, your vagina.  Both women and men have pelvic floor muscles, and therefore both women and men can experience pelvic floor muscle issues.

The pelvic floor muscles attach to your pubic bone at the front, tailbone (coccyx) at the back, and to your sitting bones around each side.  They form a hammock like structure that squeezes and lifts up inside as the muscles contract, and let go to relax.  The picture below (from https://www.continence.org.au/pages/how-do-pelvic-floor-muscles-help.html) shows the anatomy and muscles in both women (right) and men (left).

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Why is it important to exercise your pelvic floor muscles?

Like any muscles, the pelvic floor muscles can be weak, stretched, tight, sore, injured, underactive, overactive, uncoordinated or just not functioning properly.  They can be consciously contracted and exercised, but are often forgotten in regular exercise routines. The pelvic floor muscles should be exercised regularly to keep them working optimally, but it is important that you exercise them correctly, with a program that is right for you (for example, it can be detrimental to try and strengthen a muscle that is overactive). 

The pelvic floor muscles are very internal muscles, that can’t really be seen from the outside.  Therefore when you contract them, it is very difficult to tell if you’re doing it right - you can’t see much happening and rely solely on the feeling you get. If the muscle is weak, or if it is too tight, you may not get much feeling at all, or you may be using other “cheat” muscles to help you out. Many people contract their pelvic floor muscles incorrectly due to these reasons.  That’s where pelvic floor physios can help!

We know that 1 in 3 women experience urinary incontinence, and 1 in 2 (who’ve ever had a baby) develop a degree of pelvic organ prolapse, at some stage in their life.  Often women put up with these symptoms, perhaps not realising much can be done (that it’s “just a part of having children”).   In fact, lots can be done to improve, and often cure, these symptoms.  There is significant scientific evidence that an individualised pelvic floor muscle training program can assist with a broad range of conditions, particularly relating to incontinence and prolapse.  There is also evidence suggesting that having healthy, well functioning pelvic floor muscles can help prevent these issues occurring later in life - so really the question should be why not exercise your pelvic floor?

How can Pelvic Floor Physiotherapy help?

Pelvic floor physiotherapists can accurately assess your pelvic floor muscle function in relation to any symptoms you may be experiencing.  We look at the strength, coordination, endurance, tone and overall function of the muscles and help you to understand how to contract, relax and exercise the muscles properly.  Some people need to be taught the correct technique, others need to work on strength and coordination, whereas others need to learn how to relax their muscles.  Sometimes we need to stretch and release the pelvic floor muscles (just like any other muscle!).

A pelvic floor physiotherapy consult usually involves a comprehensive assessment, which is important to help understand all of your symptoms (sometimes people don’t realise that some of the things they regularly experience could be related to their pelvic floor!).  We then will work with you to develop a management plan that is achievable and works for you. There is not a “one size fits all” exercise program.  A pelvic floor physiotherapist will work very closely with you to develop an individualised, targeted program to help you achieve your goals, whatever they may be. Often these programs can be completed in a few minutes a day, anywhere, with no, or minimal, equipment.

Pelvic floor physiotherapists also use a range of other management strategies, such as manual therapy, bladder/bowel retraining, lifestyle advice and modifications, as well as a range of special equipment, if needed, to assist in the management of your condition. We will work closely with any doctors/specialists and other allied health professionals involved in your care.

We understand how confronting and difficult it can be to seek help and discuss some of these issues, but we treat you and your consults with compete confidentiality, empathy, respect and understanding.  Often patients are very relieved following a consult - to know they are not alone, these issues are in fact VERY common, and that often, something relatively simple and easy, can be done to greatly improve their symptoms. 

If you’d like to learn more, or book a confidential appointment, contact your pelvic floor Physiotherapist today.

A more comprehensive (but not conclusive!) list of conditions that pelvic floor physiotherapists may treat

Bladder

  • Stress Incontinence 

  • Urge Incontinence 

  • Urgency & Frequency

  • Voiding Dysfunction

  • Prolapse

Bowel

  • Incontinence

  • Urgency

  • Constipation 

  • Difficult defecation

  • Prolapse

Pain

  • Dyspareunia (pain with intercourse)

  • Vaginismus

  • Endometriosis  

  • Pain associated with previous pelvic surgeries

  • Chronic pain

  • Genital pain

  • Pudendal nerve impingement 

  • Pain associated with chronic vulval changes (i.e. dermatological)

  • Vulvodynia

Surgery (Preparation and Rehabilitation)

  • Vaginal Hysterectomy

  • Prolapse Repairs

  • Incontinence procedures

  • Prostatectomy

  • TURP (if any incontinence following)

Pregnancy and Postnatal

  • Any incontinence issues or pain in pregnancy

  • Advice and preparation for labour

  • Pelvic floor rehabilitation and advice for return to exercise post any delivery

  • Birth injuries/3rd & 4th degree tears

  • Difficult or prolonged deliveries

  • Caesarian recovery

WomenCristy Houghton